MHOO53

Q1. Define HMIS. Discuss its benefits in detail.

Health Management Information System is an information system specially designed to assist in the
management and planning of health programmes, as opposed to deliver.
1. Better Resource Utilization: Tele-diagnostic features allow for better utilization of physicians and
related hospital staff; thereby expediting diagnoses. Potential effects include greater satisfaction of
providers, patients and their families, and possible increased retention rates of staff.
2. Increased Diagnostic Accuracy: Diagnosis accuracy is always a huge concern for the medical
community; therefore, the Tele-diagnostic phase of a HMIS project is considered a primary benefit.
It is easier for PCPs (Primary Care Providers) to get expeditious diagnoses, for doctors to get
second opinions and for educators to correctly train our next generation of physicians. This greater
access to specialists helps ensure that more patients will get the appropriate level of care and
therefore be treated correctly, the first time.
3.Greater Visibility and Tracking: HMIS allows for greater visibility and tracking of patient health
information, provides quality information, population trends, and business transactions. Closer
patient monitoring results in decisions at earlier disease states and earlier interventions, with less
associated costs and fewer hospitalizations. Tracking physician diagnostic accuracy can reduce
malpractice claims and related medical errors; furthermore population trend tracking more rapidly
resolves epidemic and health issues.
4. Increased Productivity of the Health System: HMIS allows for the routing of consults to a
specialty hospital rather than to a general network hospital or provider. At sites where specialists are
not utilized to capacity, the health system can eventually shift the workload to improve utilization.
This would allow for better utilization of physicians at remote sites, with the potential for primary
care providers providing the needed care with guidance and evaluations from the specialists.
5. Increased Ability to Enhance and Measure Health and Fitness of Patients: By improving access to
tele-evaluations in a timely manner, technology enables the early coordination and treatment of
learning disabilities and associated health conditions, thus improving the health status of patients.
6. Increased Economic Productivity: The provision of adequate healthcare services to the citizens
will provide a healthier, happier citizenship. In addition, any efficient system will reduce stress and
therefore better serve your nation.
7. Improved Utilization of Health System Staffing Model: The opportunity to better use specialist
care by consulting at remote clinics and the ability to fill unproductive downtime is a possible
HMIS benefit. Depending upon the magnitude and span of the final project, a reduction in the size
and skill mix of the health system-staffing model is probable. Improved access may result in
shortened or avoided hospital stays, and a marked increase in health status of the patient and family.
8. Increased Ability to Promote and Measure Patient (Citizen) Satisfaction: HMIS enables
collaboration between physicians, patients, and ancillary professionals with access to specialists and
improved access to information. This collaboration will improve provider satisfaction and lead to
improved retention rates and enhanced patient care. The improved information directly relates to
considerable improvements in the quality of care and patient satisfaction.

9. Provision of Earlier Intervention: The importance of early intervention in evaluation and

treatment cannot be stressed enough. Normally, the initial patient presentation is in a primary care
setting. Referral to a specialist adds a time delay, a stress factor to the patient and the potential that
the patient will not return.

Q2. Explain the steps involved in designing and implementation of Hospital Information
System.
1. System Designing: - System design is the creative, technical process of converting information
system requirements into a detailed set of specifications for a system. Selection of a design
approach for a health services information system should be based upon completed systems
analysis, and should be carried out in accordance with the master plan for information systems
development. Systems design is the technical process of converting information system
requirements into a detailed set of specifications for the new systems.
2. Forms Designing
A form designing is the process of preparing the required format of the forms to capture the data
and to present reports. The designing of the forms should be of standard chronological order and
user friendly, so that capturing and keying of the data by the end users will be made easy. The forms
should have a clear heading as to the forms are meant for, and the data labeling which identifies the
data name for the data to be entered. Data capturing area should be highlighted in such a way that
no data will be left an entered. A data check system should also be made to see if any data is left
free without being entered. There should a mechanism that should give a caution message before
going for the next process.
3. Data Designing (Table Definition)
The Data designing is the selection of the data to be used. The names given to the data should be
closely related to the item which is going to be stored (e.g. the data name in which the patients
name is to be stored can be "ptname"). Then for each data item, the type of the data should be
decided. The type of data can be alphabetic, numeric or alphanumeric, etc. The data items list,
involved in the whole information system has to be prepared along with the information such as the
name of the data, data type, description (for what it is going to be used) with examples. The data
that is selected should be supported with detailed description to clarify the data used with examples.
4. Data Flow Diagram
Data Flow Diagram is a graphic tool and analyzes the movement of data through a system, manual
or automated, including the process, storing of data and delays in the system. Data flow diagrams
are the central tool and basis from which the other components are developed. The transformation
of data from input to output, through the process, may be described logically and independently of
the physical components. For example computers, file cabinets, disk units and word processors
associated with the system. They are termed as logical data flow diagrams. In contrast, the physical
data flow diagrams show the actual implementation and the movement of the data between people,
departments, and work stations.
Q3. Explain telemedicine. Discuss the current scenario of telemedicine in India.

Telemedicine is a part of E-health. Telemedicine is the exchange of medical

information through an audiovisual medium. It is usually done when the distance
becomes a crucial factor for medical consultations. Telemedicine is making rapid
progress in the field of medicine.
Current scenario of telemedicine in India.
India, with its diverse landmass and huge population, is an ideal settingfor
telemedicine. Telemedicine activities were started in 1999. The IndianSpace Research
Organization has been deploying a SATCOM-based tele-medicine network across the
country since that year. Various government agenciesDepartment of Information
Technology and Ministry of Health Family Welfare, state governments, premier
medical and technical institutions of Indiahave taken initiatives with the aim to
provide quality health-care facilities to the rural and remote parts of the country. The
Government of India has planned and implemented various national-level projects and
also extended telemedicine services to South Asian and African countries. Efforts are
taking place in the field of medical e-learning by establishing digital medical libraries.
Some institutions that are actively involved in tele-medicine activities have started
curriculum and no curriculum telemedicine training programs. To support telemedicine
activities within the country, the Department of Information Technology has defined the
Standards for Telemedicine Systems and the Ministry of Health & Family Welfare has
Constituted the National Telemedicine Task Force. There are various gov- ernment and
private telemedicine solution providers and a few societies and associations actively
engaged to create awareness about telemedicine within the country. With its large
medical and IT manpower and expertise in these areas, India holds great promise and
has emerged as a leader in the field of telemedicine.
Q4. Describe the factors that have led to review the current health policy.
The following factors have led to review the current health policy:
The decentralisation program planned by the government includes the division of health
services. This plan also directs the transfer of authorities and responsibilities to various
divisions of health service systems.

Rise in the number of donor agencies that operate in their own way, needs a better coordination

The paradigm of how we view chronic diseases is also shifting. The relationship between chronic
diseases and non-communicable diseases has often been confused as synonymous, or at least
closely linked; however, this notion is increasingly being exposed as outdated. Today, we know that
infectious agents such as human papillomavirus (HPV), hepatitis B virus (HBV), and Helicobacter

pylori can cause cancer of the cervix, liver, and stomach, respectively. Moreover, as life
expectancies rise in most countries due to better and more available healthcare, chronic disease
prevalence is increasing in populations that perhaps would have had shorter life expectancy in the
past, presenting new demands for struggling health systems to improve the health of the middleaged and the elderly. Likewise, our knowledge on how to combat some diseases such as HIV/AIDS,
is gradually transforming once fatal infectious diseases into long-term chronic conditions.
These trends, together with the worldwide increase in hypertension and cancer due to population
aging and modifications in health behaviors, contribute to the sharp rise in the prevalence of chronic
diseases. These pathologies now cause the greatest share of death and disability in the world. In
2005, at least 35 million people of all ages, nationalities, and socioeconomic levels died from heart
disease, stroke, cancer, diabetes, respiratory disease, and other chronic diseases.4 In this paper, we
have chosen to focus on three major chronic conditions: cardiovascular disease (CVD) (heart
disease and stroke), cancer, and diabetes. Together, these conditions are not only responsible for
most chronic disease morbidity, but also around 45 percent of total mortality worldwide.

Q5. Explain the significance of health information system in nursing education.

Health Information System in the nursing education helps the future nurses to analyse, how this
type of an information system would assist them in their day to day activities, which we discussed
in the previous section. Before discussing about the significance of Health Information Systems in
nursing education, let us quickly get an understanding of the Health Information System.
Health Information System is defined as, "A combination of health statistics from various sources,
used to derive information about health status, health care, provision and use of services, and
impact on health".
Health Information System is an information system that refers to the science of management of
information in health care, and its application to support clinical research, decision making, and
practice. It deals with the conditions under which data and records are shared with other fields, or
areas that improve patient care. It is extensively used in the fields of nursing, clinical care, medical
research, and pharmacy. It includes information and communication systems, clinical guidelines,
and formal medical terminologies. In short, it applies to all subjects that involve information
technology, health care, and the interaction of information.
Nurses must be educated in Health Information Systems, to prepare them to participate in the
implementation of the system. They must also be informed about the importance of data integrity, to
support decision making related to patient care. Appropriate methods must be implemented to train
this workforce, with the recognition that an investment in training can bring about the best of all
that is already being invested in highly skilled and specialised nurses. This also tells us that, it is
important for nurses to be familiar with the potential influence that the Health Information Systems
implementation, can have on nursing practice, the nursing profession, and on advancing nursing
knowledge.
The significance of Health Information System in nursing education for the nurses will assist them
in their prospective career in the following ways:

 It helps them to take initiative in the adoption of a successful electronic Health Information
System.
It helps them to analyse the importance and use of Health Information Systems.
It helps them to analyse how the healthcare industry is becoming more reliant on technology to
manage patient records, compare and store diagnosis, and to keep track of patients medications.
It helps to learn the working of medical software programs, embedded in Health Information
Systems.
It helps them to know the procedure to assist the doctors to review any patients full medical
background. This review is needed in order to make a diagnosis, prescribe medications, recommend
surgery or make changes to patient care.

Q6. The Hospital management is at crossroads - the dilemma faced by them is whether they
should automate the medical records department in the hospital or continue using the manual
records storage system. With your knowledge about electronic medical records, how will you
help them in taking the right decision in this regard?
Advantages of EMR
EMR contains medical history of your patients which include treatment or medical procedure, drugs
they are allergic to and so on. EMR provides completeness in the patients' data, which consists of
both past and current medications.
Some of the advantages of implementing EMR software are:
Repository of vital clinical information: An integrated electronic medical record system helps
you to access medical records at the speed of modern computer. It can also manage, share, collect
and protect all the vital medical information without lose.
Manage risk at lower cost: The EMR systems provide 24-hour information, which help to make
better decision, reduce errors, improve results, and lower the risk of negligence. Information such as
admission, service delivery, coding/billing accuracy, treatment, lab, and all other
information of the clinical operations are well maintained at the lower operating costs. Example:
The Medical Group Management Association recently calculated that staffing per physician can be
reduced after implementing an EMR system.
Quality of care: Quality patient care is obtained by integrating and retaining your patients
information. EMR maintains privacy requirements by providing the business professional an
appropriate access to its patient data. It offers clinical treatments on time and good tools to manage
the entire process.

 Information Integration Capability: Integrated solutions create a clinical healthcare system that
combines the critical patient information with the varied departments. The EMR system interacts
with external system such as Laboratories, Pharmacies, Imaging Centres and Hospitals via HL7
interfaces. With this information integration capability, you can facilitate better quality care and
manage risks.
The major reasons to buy an EMR are:
To help general practitioners at remote locations in seeking expert specialists advice located
elsewhere in the world.
To have quick and easy transfer of patient details for sharing with other doctors/institutes.
To have more affordable private practice.
To develop the quality of care.
To help general practitioners at remote locations in seeking expert specialists advice located
elsewhere in the world:
Globalisation and interoperability of EMR systems in different countries has helped general
practitioners to seek guidance from specialists located in other cities or abroad. EMR assures that
accurate medical record and history are available to physicians and medical experts regardless of
their geographic locations.
Return on Investment (ROI):
The concept of Return on Investment (ROI) is similar to that of Cost Benefit Analysis. This is
considered as final steps in the selection process. You must be overlook the publicity of some
vendors claims and must concentrate on some practices that have experienced their ROI related
claims.
At the same time, you must look after the general costs in EMR implementation such as billing,
networking and other computer systems. Implementation of EMR software will also incur some
additional costs such as hardware and software maintenance and upgradation.